HIV and Injection Drug Use: Syringe Services Programs for HIV Prevention

Dear Colleague,

November 29, 2016

Today, the Centers for Disease Control (CDC) released a new Vital Signs on HIV and injection drug use, which includes

• A Morbidity and Mortality Weekly Report (MMWR), “Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs — United States,” and
• A fact sheet, “HIV and Injection Drug Use: Syringe Services Programs for HIV Prevention.”

Together, we have made great progress in reducing HIV infections among persons who inject drugs (PWID). During 2008–2014, annual HIV diagnoses dropped by almost 50% among PWID. However, the prescription opioid and heroin epidemics pose new challenges for preventing HIV, as well as viral hepatitis and other blood-borne and sexually transmitted infections.

Data from 22 cities show that many PWID share injection equipment, putting them at high risk for HIV and hepatitis B and C infection. Last year, 40% of new PWID (those who have been injecting for 5 years or less) reported sharing syringes, and only 1 in 4 got all their syringes from sterile sources, such as syringe services programs (SSPs).

This Vital Signs highlights the importance of expanding access to SSPs, which provide sterile needles and syringes and ideally offer many other comprehensive services to help improve the health of PWID and their communities, such as treatment for substance use disorder, HIV and hepatitis testing and linkage to treatment, and safe disposal of used syringes.

Successful SSPs require the full collaboration of health departments, state and local lawmakers, law enforcement, health care providers, and other community partners. State and local health departments can provide information on where HIV prevention services are needed and work with law enforcement and local leaders to get support for SSPs, where permitted by law. Partnership with law enforcement and local officials is essential to ensure access and encourage PWID to use the life-saving services SSPs provide.

The science is clear: SSPs reduce HIV risk and are not associated with an increase in injection drug use. They are a powerful tool that can help us avoid new HIV infections, reduce injection drug use in our communities, and address other health problems faced by PWID.

The National HIV/AIDS Strategy has identified PWID as a priority population for HIV prevention interventions. Because of changes in federal law, federal funds can now be used in some circumstances to support SSPs except for the purchase of needles and syringes, which can be purchased using nonfederal funding. CDC guidance is available for CDC-funded partners interested in expanding or implementing SSPs. CDC is committed to working with our partners to apply the most effective tools to prevent HIV among PWID.

We invite you to visit the Vital Signs website, read the materials, and share them with your colleagues. Thank you for your work in HIV prevention and care. We are getting closer to the day when new HIV infections are rare in the United States.

Sincerely,

/Jonathan Mermin/
Jonathan H. Mermin, M.D., MPH
RADM and Assistant Surgeon General, USPHS
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/nchhstp

/Eugene McCray/
Eugene McCray, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv